Eminent doctors: Their lives and their work; Vol. 1 of 2

by G. T. Bettany

FOOTNOTES:

[12] Author of the defamatory so-called Life of John Hunter, 1794.

[13] “Life of John Hunter,” by Drewry Ottley, 1835.

[14] Life of John Hunter, prefixed to the treatise on the Blood, Inflammation, &c.

[15] Medical Times and Gazette, March 3, 1877.

[16] Medical Times and Gazette, Feb. 17, 1877.

[CHAPTER VI.]
EDWARD JENNER AND VACCINATION.

Modern preventive medicine may be said to date from the introduction of inoculation for smallpox in the early part of the eighteenth century. It is much more profitable to dwell on the history of the second step in this direction, a far greater one, due to the genius of one man, Edward Jenner, whose Life by Dr. Baron, though not a biographical masterpiece, is the source of much valuable information.

The name of Stephen Jenner had been handed down from generation to generation in Gloucestershire, and the Rev. Stephen Jenner, father of Edward, was vicar of Berkeley when his famous son was born, on May 17, 1749. The father, however, died in 1754, and an elder son, another Stephen Jenner, Fellow of Magdalen College, Oxford, is credited with some attention to his education. But his school life was not prolonged, for about the thirteenth year of his age he commenced preparation for a medical career by entering upon apprenticeship to Mr. Daniel Ludlow, a medical practitioner at Sodbury near Bristol, with whom he remained six years.

Young Edward, when a fine ruddy boy of eight, was, with many others, put under a preparatory process for inoculation for smallpox. This was indeed a formidable proceeding, lasting six weeks. He was first bled, to ascertain whether his blood was “fine;” was then purged repeatedly till the ruddy youth became emaciated and feeble; and all the while was kept on a low diet, and dosed with some drink which was supposed to sweeten the blood. This is appropriately termed a “barbarism of human veterinary practice,” but it was followed by exposure to contagion from others in a state of severe disease. By good luck the boy got off with a mild attack; but we may well ascribe to the lowering preparatory treatment he had undergone, that he never could as a child enjoy sleep, and was constantly haunted by imaginary noises. All his life long he was too acutely alive to these impressions and to any sudden jar.

It is perhaps more interesting, it is certainly more important, to notice the influence exerted upon one mind by another, than to examine the influences of any material objects upon human nature. In this light we may view with pleasure the relations which existed between Jenner, his elder brother already mentioned, and the great anatomist, John Hunter. The ties of affection and esteem must have been strong which drew the young doctor from the attractions of London, from constant association with his admired friend in his studies, from opportunities to inquire such as those afforded by the arrangement of Sir Joseph Banks’s collection made during Captain Cook’s celebrated voyage, from prospects of gain and worldly advancement, to the retirement of a country village, the isolation and the simplicity of rural existence. We can hardly overestimate the benefits derived by the developing mind of the young doctor from his daily intercourse for two years with such a preceptor as John Hunter. The impression was mutual, for we find Hunter years afterwards writing to Jenner, “I do not know any one I would sooner write to than you: I do not know anybody I am so much obliged to.” A correspondence full of interest on subjects of natural history was kept up between them. Hunter’s appreciation of his friend’s attainments was shown markedly when he formed the plan of a school of natural history and human and comparative anatomy, and asked Jenner to come and be his partner in the undertaking. Very many particulars of experiments and inquiries in natural history by Jenner were communicated to Hunter, and were of essential service to him. His most important published paper in natural history was that on the Cuckoo, published in the “Philosophical Transactions” for 1788.

Jenner’s name has been so exclusively connected in the popular mind with the subject of vaccination, that his ability as a practitioner and his originality in many departments of medicine and surgery have been somewhat lost sight of. No doubt this was much aided by his own modesty; but in the treatment of many diseases his views, founded on the improved anatomy and physiology he had learned from Hunter and his own acute observation, were far in advance of his time.

It was perhaps, however, by his sympathetic qualities of heart that Jenner most of all obtained and maintained the influence which he possessed. He could truly rejoice with those that rejoiced, and weep with those that wept. In him uncommon delicacy of feeling co-existed with a joyous and lively disposition; and his gentlemanly manners made him welcome everywhere. He was ever observant of natural phenomena, and loved nothing better than to persuade some friend to ride with him during his long journeys through the countryside. Those who enjoyed the pleasure have described the vivid and imaginative fervour which characterised his conversation, whether in reference to his own feelings or the beauties of the scenery around, and the captivating simplicity and ingenuity with which he explained phenomena of animal and vegetable life which came under notice. In fact he never met any one without endeavouring to gain or to impart instruction.

Among the many proofs of Jenner’s sagacity and acuteness in matters outside medicine should be mentioned the following, recorded by Sir Humphry Davy, showing that Jenner anticipated the late Charles Darwin in his views of the important effects produced by earthworms upon the soil. “He said the earthworms, particularly about the time of the vernal equinox, were much under and along the surface of our moist meadow-lands; and wherever they move, they leave a train of mucus behind them, which becomes manure to the plant. In this respect they act, as the slug does, in furnishing materials for food to the vegetable kingdom; and under the surface, they break the stiff clods in pieces and finally divide the soil.”

His appearance and manner in this early portion of his life are thus described by his intimate friend, Edward Gardner: “His height was rather under the middle size, his person was robust, but active and well formed. In his dress he was peculiarly neat, and everything about him showed the man intent and serious, and well prepared to meet the duties of his calling. When I first saw him it was on Frampton Green. I was somewhat his junior in years, and had heard so much of Mr. Jenner of Berkeley that I had no small curiosity to see him. He was dressed in a blue coat and yellow buttons, buckskins, well-polished jockey-boots, with handsome silver spurs, and he carried a smart whip with a silver handle. His hair, after the fashion of the times, was done up in a club, and he wore a broad-brimmed hat. We were introduced on that occasion, and I was delighted and astonished. I was prepared to find an accomplished man, and all the country spoke of him as a skilful surgeon and a great naturalist; but I did not expect to find him so much at home on other matters. I who had been spending my time in cultivating my judgment by abstract study, and smit from my boyhood with the love of song, had sought my amusement in the rosy fields of imagination, was not less surprised than gratified to find that the ancient affinity between Apollo and Esculapius was so well maintained in his person.”

So informing and yet witty, so full of life, so true to life was his conversation that the chance of sharing it was eagerly embraced, and his friends rode many miles to accompany him on his way home from their houses, even at midnight. His poetical fancy occasionally vented itself in little pieces of verse, one of which, entitled “Signs of Rain,” beginning—

“The hollow winds begin to blow,”

will probably long prove of interest in children’s collections of verse.

Some of his epigrams are very apt, as this on the death of a miser—

“Tom at last has laid by his old niggardly forms,

And now gives good dinners; to whom, pray? the worms.”

Singing and violin and flute playing were favourite amusements of his; and in his later years he would lay aside all cares for a time and sing one of his own ballads with all the mirth and gaiety of his youthful days.

Science and social intercourse were combined in two societies of which Jenner was the soul—one he called the Medico-convivial, which met usually at Radborough, the other the Convivio-medical, assembling at Alveston.

At the meetings of these societies Jenner would often bring forward the reported prophylactic virtues of cowpox, and earnestly recommend his medical friends to inquire into the matter. All his efforts, however, failed to induce them to take it up; and the subject became so distasteful to them that they at one time threatened to expel him if he continued to harass them with so unprofitable a subject.

Dr. Jenner did not marry till March 6, 1788, when Miss Catherine Kingscote, a lady belonging to a well-known Gloucestershire family frequently furnishing representatives to Parliament, became his wife. The union was very happy, but Mrs. Jenner’s delicate health for many years caused great anxiety and needed constant attention.

In 1792 Jenner became M.D. of St. Andrews, with the view of giving up much of his fatiguing general practice. In 1794, at the age of forty-five, he suffered from a severe attack of typhus fever, which threatened to prove fatal. At this time the experiments in proof of vaccination had not been made, and if he had died, the world in all probability might have waited long for the introduction of this great novelty.

Many who learn that vaccination was made known to the world in 1798, when Jenner was forty-nine years old, do not know that the subject attracted his attention in his youthful days as a country surgeon’s apprentice, and that his faculties were ever after engaged upon the matter at every convenient opportunity. He repeatedly mentioned the subject of cowpox to his great teacher, John Hunter, when studying with him in London. Hunter never damped the ardour of a pupil by suggesting doubts or difficulties; but it does not appear that he was specially impressed by what he heard. Yet he made known Jenner’s information and opinions both in his lectures and to his friends. But for many years Jenner’s ideas were poohpoohed by medical and other authorities whom he met in his country practice. They believed many had had smallpox after cowpox, and that the supposed protective influence of the latter was due to something in the constitution of the individual.

Not till 1780 did Jenner fully disclose to his devoted friend Edward Gardner his hopes and fears about what he felt to be his great life-work. He then described to him the various diseases which attacked milkers when they handled diseased cows, and especially that form which afforded protection against smallpox; and with deep and anxious emotion expressed his hopes of being able to propagate this latter form from one human being to another, so as to bring about the total extinction of smallpox.

The exceeding simplicity of the ultimate discovery makes it difficult for us nowadays to imagine the circumstances under which Jenner had to grope his way in the imperfect twilight, and the perplexities by which he was beset in arriving at true conclusions. Both his own observation and that of other medical men of his acquaintance proved to him that what was commonly called cowpox was not a certain preventive of smallpox. But he ascertained by assiduous inquiry and personal investigation that cows were liable to various kinds of eruptions on their teats, all capable of being communicated to the hands of the milkers; and that such sores when so communicated were all called cowpox. But when he had traced out the nature of these various diseases, and ascertained which of them possessed the protective virtue against smallpox, he was again foiled by learning that in some cases when what he now called the true cowpox broke out among the cattle on a dairy farm, and had been communicated to the milkers, they subsequently had smallpox.

It was this repeated failure to arrive at a perfect result which perhaps gave the stimulus that led Jenner to ultimate triumph. The fact that he was on the scent of a discovery which in some form had a promise of indefinite blessing, made him redouble his efforts when most perplexed. He conceived the idea that the virus of the cowpox itself might undergo changes sufficient to deprive it of its protective power, and yet enable it to communicate a disease to the milker. Thus he at last came on the track of the discovery that it was only in a certain condition of the pustule that the virus was capable of imparting its protective power to the human constitution.

Having thus steered his way safely through all the pitfalls which might have destroyed the accuracy of his results, Jenner was able to go on to the next stage, that of putting his theory to the test. It is singular how long he was before he had an opportunity of further experiment. In 1788 he showed a drawing of the cowpox as it occurred in milkers to Sir Everard Home and others in London. Various eminent medical men, Cline, Adams, Haygarth, heard of and discussed the matter, and encouraged Jenner’s inquiries. But it was not till May 14, 1796, that he had an opportunity of transferring cowpox from one human being to another. Sarah Nelmes, a dairymaid who had been infected from her master’s cows, afforded the matter, and it was inserted by two surperficial incisions into the arms of James Phipps, a healthy boy about eight years old. The cowpox ran an ordinary course with no ill effect, and in July Jenner writes to Gardner: “The boy has since been inoculated for the smallpox, which, as I ventured to predict, produced no effect. I shall now pursue my experiments with redoubled ardour.”

Jenner did not, even now that he had attained to certainty in his own mind, rush precipitately into publicity, although his benevolent desires to avert the scourge of smallpox from humanity strongly urged him to do so. Still less did he yield to the temptation to establish himself as a practitioner with a specialty for warding off smallpox, which might have led him speedily to fortune. He was as if forearmed against the stringent requirements which would be made as to the proofs of such a discovery if made gratuitously public. At this time he says: “While the vaccine discovery was progressive, the joy I felt at the prospect before me of being the instrument destined to take away from the world one of its greatest calamities, blended with the fond hope of enjoying independence and domestic peace and happiness, was often so excessive that, in pursuing my favourite subject among the meadows, I have sometimes found myself in a kind of reverie. It is pleasant to me to recollect that these reflections always ended in devout acknowledgments to that Being from whom this and all other mercies flow.”

Until the spring of 1798 Jenner had no further opportunity of pursuing his inquiries, for the cowpox disappeared from the neighbouring dairies. At last he had matured his research, and it was ready for publication. Before sending it to the printers it was most carefully scrutinised by a number of friends at Rudhall, near Ross, in Herefordshire, the seat of Mr. Thomas Westfaling. Their sympathy encouraged him and their judgment approved of his work, which none who read Jenner’s modest and now classic recital, “An Inquiry into the Causes and Effects of the Variolæ Vaccinæ,” bearing date June 21, 1798, can wonder at. Previous to this date, however, Dr. and Mrs. Jenner had been two months in London, experiencing much mortification from the fact that no one in London could be obtained as a patient to be inoculated with cowpox. Dr. Jenner often stated that his patience had been exhausted on that occasion: and it remained for Henry Cline to perform the first successful vaccination in London. Finding that subsequent inoculation with smallpox failed to give his patient any disease, Cline expressed his opinion that this promised to be one of the greatest improvements ever made in medicine; and he begged Jenner to remove to London, promising him a practice of ten thousand a year. Jenner’s sentiments on this matter are characteristically expressed in the following extract: “Shall I, who even in the morning of my days sought the lowly and sequestered paths of life—the valley, and not the mountain; shall I, now my evening is fast approaching, hold myself up as an object for fortune and for fame? Admitting it as a certainty that I obtain both, what stock should I add to my little fund of happiness? My fortune, with what flows in from my profession, is sufficient to gratify my wishes; indeed, so limited is my ambition and that of my nearest connexions, that were I precluded from future practice I should be enabled to obtain all I want. And as for fame, what is it? a gilded butt, for ever pierced with the arrows of malignancy.”

The first lady of rank who had her child vaccinated was Lady Frances Morton (afterwards Lady Ducie). The Countess of Berkeley very early promoted Jenner’s success and ardently advocated vaccination.

A certain Dr. Woodville, eager to rank among the vaccinators, discovered cowpox in a dairy in Gray’s Inn Lane, in January 1799, found that the milkers became infected, and took from them matter with which he vaccinated a number of persons; but contrary to Jenner’s practice, he proceeded to insert smallpox matter in their arms on the third and fifth days after vaccination, as if that could afford a fair trial of the new method. No wonder that the patients exhibited pustules like those of smallpox, and this was the first of the many disasters that arose from the injudicious zeal of Jenner’s first followers. This same Dr. Woodville, in an interview with Jenner in March of the same year, showed himself so little acquainted with the real character of cowpox, that he described it as having been communicated by effluvia; and that the patient had it in the confluent way. Jenner remarked on this: “Might not the disease have been the confluent smallpox communicated by Dr. Woodville, as he is always full of the infection?”

Notwithstanding the mistakes of injudicious friends vaccination began to spread in 1799, largely through the aid of those friends of Jenner who themselves became inoculators—including many who were not medical practitioners. In the same year it came into notice on the continent, the “Inquiry” having become known in Vienna, Hanover, and Geneva. In particular Dr. de Carro in Vienna became its most zealous and judicious advocate, and greatly contributed to the striking diminution in the ravages of smallpox which soon became evident in that city through the introduction and wide spread of vaccination. A little later, vaccine matter was first sent to Berlin. The same year vaccination became known in the United States, Professor Waterhouse of Cambridge, Mass., being the first to appreciate its importance. He as soon as possible vaccinated his own children, and then had one of them publicly inoculated with smallpox; and no infection following, the practice became at once established in the United States. Some contamination with smallpox having taken place by injudicious action as in England, matter was obtained direct from Jenner, and President Jefferson, with his sons-in-law, in 1801, set the example of vaccinating in their own families and those of their neighbours, nearly 200 persons. France and Spain had also followed in the wake, and almost all Europe was now being vaccinated.

We cannot follow the details of the successful introduction of vaccination as by a triumphal progress all over the world, proving its efficacy on men of all colour, of all civilisations, of all climates. Sir Ralph Abercrombie’s expedition to Egypt was the first armed force submitted to vaccination, and its good effects were most evident. At Palermo it was not unusual to see on the mornings of public inoculation at the hospital a procession of men, women, and children, conducted through the streets by a priest carrying a cross, on the way to be inoculated. The medical officers of the British navy in 1801 presented Dr. Jenner with a gold medal in honour of his discovery.

Smallpox was still committing great ravages in India and Ceylon, and Jenner exerted himself to the utmost to transmit vaccine matter to the East. The early attempts all failed, some from accident, such as the loss of an East Indiaman at sea, others from inexperience in sending the virus so great a distance, exposed to such vicissitudes of climate. Dr. Jenner proposed to the Secretary of State to send in some ship to India a number of soldiers who had not had smallpox, and to vaccinate them in succession by appointing a skilled surgeon to accompany the vessel; but those in office could not see the wisdom of this plan. Consequently the noble discoverer resolved himself to do what was so needful, and while seeking to defray part of the cost by a public subscription, he headed it with a subscription of a thousand guineas. But before the project could be matured, news arrived of the successful introduction of vaccine matter into Bombay, in consequence of its successive transfer to Constantinople, to Bagdad, to Bussora, and thence by sea to Bombay. The self-denying enthusiasm of Dr. Jenner is, however, as conspicuous as if his expedition had been fitted out as he intended.

The simple narrative which the great man himself gave in 1801 in a pamphlet only extending to eight pages, deserves reproducing in every account of the discovery. Its simplicity is more forceful than any decorative treatment could have rendered it. “My inquiry into the nature of the cowpox commenced upwards of twenty-five years ago. My attention to this singular disease was first excited by observing, that among those whom in the country I was frequently called upon to inoculate, many resisted every effort to give them the smallpox. These patients I found had undergone a disease they called the cowpox, contracted by milking cows affected with a peculiar eruption on their teats. On inquiry, it appeared that it had been known among the dairies time immemorial, and that a vague opinion prevailed that it was a preventive of the smallpox. This opinion I found was comparatively new among them, for all the older families declared they had no such idea in their early days.”

---

“During the investigation of the casual cowpox, I was struck with the idea that it might be practicable to propagate the disease by inoculation, after the manner of the smallpox, first from the cow, and finally from one human being to another. I anxiously waited some time for an opportunity of putting this theory to the test. At length the period arrived, and the first experiment was made upon a lad of the name of Phipps, in whose arm a little vaccine virus was inserted, taken from the hand of a young woman who had been accidentally infected by a cow. Notwithstanding the resemblance which the pustule, thus excited on the boy’s arm, bore to variolous inoculation, yet as the indisposition attending it was barely perceptible, I could scarcely persuade myself the patient was secure from the smallpox. However, on his being inoculated some months afterwards, it proved that he was secure. This case inspired me with confidence; and as soon as I could again furnish myself with virus from the cow, I made an arrangement for a series of inoculations. A number of children were inoculated in succession, one from the other; and after several months had elapsed, they were exposed to the infection of smallpox—some by inoculation, others by variolous effluvia, and some in both ways, but they all resisted it. The result of these trials gradually led me into a wider field of experiment, which I went over not only with great attention, but with painful solicitude.”

The great revolution effected by vaccination can scarcely be appreciated in our days, and some testimonies from the past are continually needed. The Rev. Dr. Booker, of Dudley, which in his time contained fourteen thousand inhabitants, testified thus respecting vaccination and its striking effects: “I have, previous to the knowledge of the vaccine inoculation, frequently buried, day after day, several (and once as many as eight) victims of the smallpox. But since the parish has been blessed with this invaluable boon of Divine Providence (cowpock), introduced among us nearly four years ago, only two victims have fallen a prey to the above ravaging disorder (smallpox). In the surrounding villages, like an insatiable Moloch, it has lately been devouring vast numbers, where obstinacy and prejudice have precluded the Jennerian protective blessing, and not a few of the infected victims have been brought for interment in our cemeteries; yet, though thousands have thus fallen beside us, the fatal pestilence has not hitherto again come nigh our dwelling. The spirit of Jenner hath stood between the dead and the living, and the plague has been stayed.”

Many ladies took up the practice of vaccination with zeal and skill. Thus, up to November 1805, Miss Bayley, of Hope, near Manchester, had vaccinated two thousand six hundred persons, and a female friend of hers had vaccinated two thousand. Miss Bayley is related to have carried on her extensive vaccinations with great judgment and precision. She commenced by offering five shillings to any one who could produce an instance of the occurrence of smallpox in any person vaccinated by her. Out of the whole number of cases above mentioned, however, only one claim was made; and on referring to her books, it was found that a mark had been made against the name, indicating a suspicion that the vaccination had not been effective.

Dr. Jenner has often been reproached for encouraging unprofessional persons to practise vaccination: but it should be noted that he never did so unless the person concerned had carefully studied the subject, and could be relied on to follow his directions implicitly. In fact, some of the non-professional vaccinators were more efficient than many professional ones, for these frequently disdained to be instructed by him, and by no means followed the rules he laid down. Thus discredit came to vaccination to a great extent by the mistakes of its professional advocates.

The most extraordinary attacks were made upon vaccination and its promoters, including, of course, most virulent denunciations of its supposed anti-religious tendencies. Opposing doctors detected resemblances to ox-faces, produced in children, as they alleged, by vaccination. A lady complained that since her daughter was vaccinated she coughed like a cow, and had grown hairy all over her body; and in one country district it was stated that vaccination had been discontinued there, because those who had been inoculated in that manner bellowed like bulls.

One mode in which some doctors suffered at the time of the introduction of smallpox is not often remembered. Inoculation with smallpox was largely practised, and some medical men derived a considerable proportion of their income from this branch of their profession. It was stated on good authority that Dr. Woodville, at one time Physician to the Smallpox Hospital, having given up inoculation and largely practised vaccination, his income sank in one year from £1000 to £100; and others who refused to discontinue inoculation and advocate vaccination were more than suspected of interested motives.

The antagonism of vaccination to the so-called designs of Providence was loudly asserted. One Dr. Squirrel on this head maintained that “Providence never intended that the vaccine disease should affect the human race, else why had it not, before this time, visited the inhabitants of the globe? Notwithstanding this, the vaccine virus has been forced into the blood by the manufacturing hand of man, and supported not by science or reason, but by conjecture and folly only, with a pretence of its exterminating the smallpox from the face of the earth.” Again, he denounces “the puerility and the impropriety of such a conduct, viz., of introducing vaccination with a boasted intention not only to supplant, but also to change and alter, and, in short, to prevent the established law of nature. The law of God prohibits the practice; the law of man, and the law of nature, loudly exclaim against it.” Inoculation had been just as bitterly denounced as “dangerous,” “sinful,” “diabolical,” in numerous sermons and medical treatises, when it was introduced, less than a century before this.

No more striking evidence of the beneficial results which attended vaccination, even in Jenner’s lifetime, could be given than those which attended its introduction into Vienna, where smallpox had prevailed severely for centuries. The average number of persons who died at Vienna in each of the first five years of this century was about 14,600: of these eight hundred and thirty-five died of smallpox in the year 1800. Vaccination being introduced and extensively adopted, the number of deaths from smallpox fell to one hundred and sixty-four in 1801, to sixty-one in 1802, to twenty-seven in 1803, while in 1804 only two persons died, and these deaths were not occasioned in Vienna, one being that of a boatman’s child who caught the disease on the Danube, and the other a child sent to Vienna from a distant part of the empire already infected. Yet so long was the practice of vaccination before it spread to an equal extent in England, that nine hundred and fifty deaths occurred from smallpox in London in the last three months only of 1805.

Wherever he might happen to be, Jenner offered to vaccinate gratuitously all poor persons who applied to him at fixed times. The people of one parish, in the neighbourhood of Cheltenham, held back, while the adjacent parishes accepted the new practice to a large extent. But in one particular year the people of the reluctant parish arrived in large numbers to claim vaccination for their children. On inquiry it appeared that smallpox had been among them, causing many deaths, while those of their neighbours who had been vaccinated escaped. Yet it was not this potent argument which had been most influential, but the fact that the cost of coffins and burial for those who had died of smallpox became alarming to the parish officials, and they were moved to urge the people authoritatively to be vaccinated, and so save the parish expenses.

From this time forward for a number of years Jenner paid annual visits to London, remaining there a great part of the season, incessantly occupied in vaccinating, in giving information and instruction on the subject verbally to many medical men, in writing to a vast number of persons who corresponded with him from all parts of the world, for every one who heard of the discovery and wanted to know more about it applied to the discoverer, and in social intercourse with people of note, whom he never failed to impress by his eloquence and perspicuity. We cannot follow here the many incidents which marked these years, his intercourse with royal personages, the addresses of congratulation and gratitude which he received from all kinds of localities and bodies of people, the foundation of the Royal Jennerian Society, and the like. A few, however, must find a place.

A Dr. Pearson, to whom we shall have to refer again, distinguished himself at first as an ardent vaccinator, but subsequently he seems to have imagined himself entitled to much of the distinction which belonged to Dr. Jenner, and in order to secure this, set about forming a public “vaccine board,” in which the chief official status was assigned to himself. He succeeded in obtaining the patronage of the Duke of York and other notable persons. Addressing Jenner on the subject, in December 1799, Pearson says: “It occurs to me that it might not be disagreeable to you to be an extra-corresponding physician.... No expense is to be attached to your situation except a guinea a year as a subscriber, and indeed I think you ought to be exempt from that, as you cannot send any patients.” This was pretty well, one might think, to be addressed to Jenner: in one year after the full publication of his discovery, he was to be shunted off as an “extra-corresponding physician.” Jenner’s answer showed the sense in which he regarded it. “It appears to me somewhat extraordinary that, an institution formed upon so large a scale, and that has for its object the inoculation of the cowpox, should have been set on foot and almost completely organized without my receiving the most distant intimation of it.... For the present I must beg leave to decline the honour intended me.” After some discussion, most of the royal and influential personages who had promised to support Dr. Pearson’s institution withdrew their names from it.

At Brunn in Moravia, where Count Francis de Salm introduced and widely diffused vaccination, the people erected a temple dedicated to Jenner, and annually held a festival on his birthday.

The Dowager Empress of Russia first promoted vaccination in that empire, gave the name Vaccinoff to the first child vaccinated, had the child taken to St. Petersburg in one of her own coaches, placed in the Foundling Hospital, with a provision settled on her for life. In 1802 the Empress sent Dr. Jenner a letter signed with her own hand, with a valuable diamond ring. In fact in all foreign countries vaccination was accepted with more enthusiasm than in England. The proof of this may readily be seen in Dr. Baron’s Life of Jenner.

Meanwhile Jenner had expended a large amount of money out of his fortune, in visiting London, distributing information, giving up to a very large extent his practice at Berkeley, and being by no means recouped by profits of practice in London. His friends at length, seeing that he was now debarred from obtaining from practice an adequate reward for his great discovery, urged him to apply to Parliament for some reward. This was at last done in 1802, and the petition was recommended very strongly by the king, and considered by a committee of the House of Commons. This committee received evidence which unanimously affirmed the importance and practical value of the discovery, and almost as unanimously agreed in Jenner’s originality. Admiral Berkeley, chairman of the committee, said that Jenner’s was unquestionably the greatest discovery ever made for the preservation of the human species. A grant of £10,000 was proposed on June 2, 1802, and after a considerable discussion was carried, as against an amendment proposing to grant £20,000.

It soon appeared, however, that the House of Commons had failed to satisfy the sense of justice of the mass of people as well as of the more eminent members of the medical profession in its grant to Jenner. Sir Gilbert Blane, in an address he drew up on the subject, said: “It is the universal voice of this as well as other nations that the remuneration given to Dr. Jenner is greatly inadequate to his deserts, and to the magnitude of the benefit his discovery has conferred on mankind.”

In January 1803 was founded the Royal Jennerian Institution, under royal patronage, and with Jenner as president, to propagate vaccination in London and elsewhere. This continued its operations for some years with distinguished success; but Dr. Walker, who had been appointed resident inoculator, soon began to deviate from Jenner’s instructions, and to adopt methods calculated in Jenner’s view to bring the practice into disrepute. Consequently the dismissal of Walker was called for, but was negatived in one division, to which Walker had brought in as voters twenty persons who only paid their subscription on the day of voting. By such absurd possibilities are the steps of benefactors to their race frequently beset. The resignation of Dr. Walker took place soon afterwards, but the Jennerian Institution did not fully recover from the effects of the dissension, and on the establishment of the National Vaccine Institution in 1808 it became practically extinct.

Will it be credited that, after the decisive parliamentary vote, for more than two years the Treasury delayed to pay the money, on one pretence and another; and when at last it was paid, nearly £1000 was deducted on account of fees. Akin to this, though the amount was trifling, was a demand made upon Jenner for five pounds admission fees, when the corporation of Dublin conferred upon him the freedom of that city.

Among the multitude of testimonies of appreciation which Jenner received, not the least interesting is one which proceeded from the chiefs of the “Five Nations” of Canadian Indians, the Mohawks, the Onondagas, the Senecas, the Oneidas, and the Coyongas. Their address to him ran as follows: “Brother! our Father has delivered to us the book you sent to instruct us how to use the discovery which the Great Spirit made to you, whereby the smallpox, that fatal enemy of our tribes, may be driven from the earth. We have deposited your book in the hands of the man of skill whom our Great Father employs to attend us when sick or wounded. We shall not fail to teach our children to speak the name of Jenner; and to thank the Great Spirit for bestowing upon him so much wisdom and so much benevolence. We send with this a belt and string of wampum, in token of our acceptance of your precious gift; and we beseech the Great Spirit to take care of you in this world, and in the land of spirits.”

In 1804 one of the most beautiful of the Napoleon series of medals was struck in commemoration of the Emperor’s estimate of the value of vaccination. He was so sensible of Jenner’s claims, that he allowed his petitions for the liberation of British subjects to prevail. Napoleon was about to reject one petition, but when Josephine uttered the name of Jenner, he paused and exclaimed, “Jenner! ah, we can refuse nothing to that man.” Perhaps no more striking example of the extent to which Jenner’s influence extended outside England could be given, than the fact that numbers of persons travelled abroad or on shipboard bearing with them, in preference to a passport, a simple certificate signed “Edward Jenner,” testifying that the persons were known to him and were travelling in pursuit of health, or science, or other affairs unconnected with war. When the great war was over, and the allied sovereigns visited London, Jenner was introduced, among others, to the Emperor of Russia and the King of Prussia, by their special request.

But in Great Britain there were many things calculated to detract from Jenner’s perfect enjoyment. On various occasions the British government were by no means eager to show him a respect and honour equal to that paid to him abroad. When various government officials combined to launch a national vaccine establishment, it was at first stated that Jenner was to be director, with the stipulation that no one was to take any part in the vaccinating department who was not either nominated or approved by him. Yet soon afterwards, out of eight persons nominated by Jenner, six were rejected. Jenner himself was not admitted a member of the Board, which was composed exclusively of the four censors of the College of Physicians and the master, and two senior wardens of the College of Surgeons. In consequence of this treatment, occurring in 1808, when vaccination was so universally recognised, Dr. Jenner resigned the post of director, but was succeeded by his friend, Mr. Moore, who was thoroughly in his confidence.

A picture of Jenner’s inward life at this period, when the subject of a second parliamentary grant was being considered, may here be given from a letter of his:—“As for myself, I bear the fatigues and worries of a public character better by far than those who know the acuteness of my feelings could have anticipated. Happy should I be to give up my laurels for the repose of retirement, did I not feel it to be my duty to be in the world. I certainly derive the most soothing consolation from my labours, the benefits of which are felt the world over; but less appreciated, perhaps, in this island than in any other part of the civilised world.... Cheltenham is much improved since you saw it. It is too gay for me. I still like my rustic haunt, old Berkeley, best; where we are all going in about a fortnight. Edward is growing tall, and has long looked over my head. Catherine, now eleven years old, is a promising girl; and Robert, eight years old, is just a chip of the old block.”

In July 1806 Lord Henry Petty, who had succeeded Mr. Pitt as Chancellor of the Exchequer, carried a motion in the Commons, that the Royal College of Physicians should be requested to inquire into the progress of vaccine inoculation. The College made an inquiry, giving the fullest scope to the opponents of vaccination, and finally reported that, considering the number, respectability, disinterestedness, and extensive experience of its advocates, compared with the feeble and imperfect testimonies of its few opposers, the value of the practice seemed established as firmly as possible. In July 1807 the subject was again debated in Parliament, and a proposal to grant £10,000 was rejected in favour of one moved by Mr. Edward Morris that £20,000 be granted to Dr. Jenner.

The European inhabitants of India were from the first among the most earnest in recognising Jenner’s merits, and afforded him in many ways practical testimonies of their gratitude. About £4000 were transmitted to him from Calcutta in 1806 and following years; from Bombay £2000, and from Madras nearly £1400.

The effects of incessant labours were beginning seriously to tell on Jenner’s health, when in 1810 he lost his eldest son from consumption, in his 21st year. This event preyed much on his mind, and left him in a state occasioning great anxiety to his friends. In the same year he lost his firm friend the Earl of Berkeley, and his beloved sister, Mrs. Black. Under these troubles he felt the more acutely the calumnious attacks to which he was constantly subjected. Dr. Parry of Bath, writing to him about this time, says—“For Heaven’s sake, think no more of these wasps, who hum and buzz about you, and whom your indifference and silence will freeze into utter oblivion. Let me again entreat you not to give them one moment’s consideration, opus exegisti ære perennius. The great business is accomplished, and the blessing is ready for those who choose to avail themselves of it; and with regard to those who reject it, the evil will be on their own heads.”

In 1811 occurred the first well-authenticated case of smallpox in a boy vaccinated by Jenner, the Hon. Robert Grosvenor. The disease became severe and threatened death, when all at once the later stages were passed through rapidly, and a good recovery was made. Other vaccinated children in this family were exposed to the contagion, and did not suffer. There seemed every reason, as Jenner explained, to ascribe the failure of protection in the first case to a peculiarity of constitution which would probably have exposed the patient to a second attack of smallpox. In fact, Dr. Jenner had vaccinated the child when in weak health at a month old. Lady Grosvenor was timid, and prevailed on him, contrary to his usual practice, to make one puncture only; and the pustule that resulted was deranged in its progress by being rubbed by the nurse. Nevertheless the case created much alarm and excitement, and greatly exhilarated the anti-vaccinists. Jenner’s simple answer was to admit the fact, alleging that if ten, fifty, or a hundred such events should occur, they would be balanced a hundred times over by cases of second attacks of smallpox. “I have ever considered the variolous and the vaccine radically and essentially the same. As the inoculation of the former has been known to fail in instances so numerous, it would be very extraordinary if the latter should always be exempt from failure. It would tend to invalidate my early doctrine on this point.”

A letter of Jenner to Dr. Baron on this subject, exhibits perhaps the utmost degree of irritation that he showed. “The Town is a fool—an idiot,” he remarks, “and will continue in this red-hot, hissing-hot state about this affair, till something else starts up to draw aside its attention. I am determined to lock up my brains and think no more pro bono publico.... It is my intention to collect all the cases I can of smallpox, after supposed security from that disease.”

In 1813 the degree of M.D. was voted to Jenner by the University of Oxford. It was expected that the London College of Physicians would have followed suit by admitting him to membership, but they exacted a full examination, which Jenner at his age, and with his reputation, could not be expected to submit to. In the summer of 1814 Jenner visited London for the last time, being presented to the Czar, and having numerous interviews with his sister, the Grand Duchess of Oldenburg. On the 13th September, 1815, Mrs. Jenner died, a calamity which most deeply afflicted Dr. Jenner, and seemed to mark his retirement from active public life. It is much to be regretted that he did not live to complete and publish his own final account, and matured convictions, as to the suitable conditions of vaccination, and the modifications and imperfections to which it was liable. This engaged much of his attention in his later years, but his inquiries were interrupted by illness and by family affliction. His later years were made painful by extreme nervous sensitiveness, and he had several attacks which foreboded death by apoplexy, which ultimately occurred on 26th January, 1823. He was buried at Berkeley, by the side of his wife, on 3d February.

Jenner’s nature, says his biographer, was mild, unobtrusive, unambitious; the singleness of his heart and his genuine modesty graced and adorned his splendid reputation. Had those who opposed him known how little of selfishness, vanity, or pride entered into his composition! He made no answer to aspersions.

“All the friends who watched him longest, and have seen most of his mind and of his conduct, with one voice declare that there was a something about him which they never witnessed in any other man. The first things that a stranger would remark were the gentleness, the simplicity, the artlessness of his manner. There was a total absence of all ostentation or display; so much so, that in the ordinary intercourse of society he appeared as a person who had no claims to notice. He was perfectly unreserved, and free from all guile. He carried his heart and his mind so openly, so undisguisedly, that all might read them. You could not converse with him, you could not enter his house nor his study, without seeing what sort of man dwelt there.”

“The objects of his studies generally lay scattered around him; and, as he used often to say himself, seemingly in chaotic confusion. Fossils, and other specimens of natural history, anatomical preparations, books, papers, letters—all presented themselves in strange disorder; but every article bore the impress of the genius that presided there. The fossils were marked by small pieces of paper pasted on them, having their names and the places where they were found inscribed in his own plain and distinct hand-writing.... He seemed to have no secrets of any kind: and, notwithstanding a long experience with the world, he acted to the last as if all mankind were trustworthy, and free from selfishness as himself. He had a working head, being never idle, and accumulated a great store of original observations. These treasures he imparted most generously and liberally. Indeed, his chief pleasure seemed to be in pouring out the ample riches of his mind to every one who enjoyed his acquaintance. He had often reason to lament this unbounded confidence; but such ungrateful returns neither chilled his ardour nor ruffled his temper.”

Such was the man to whom the world was indebted for vaccination; no court or metropolitan physician, no university student, but a country doctor, a man of science and of benevolence, whose name is undying.

[CHAPTER VII.]
SIR ASTLEY COOPER AND ABERNETHY: THE KNIFE VERSUS REGIMEN.

Few men have been more renowned in their day than the great “Sir Astley.”

Astley Cooper was the grandson of a surgeon at Norwich. His father was a very estimable clergyman in Norfolk; his mother wrote novels of some repute, and was noted for her benevolence and unselfishness. Astley, the fourth son of a numerous family, was born on August 23, 1768. His youth was marked by a succession of hairbreadth escapes and exploits, demanding coolness and audacity. He had no great taste for classics or literature in youth or through life. As a youth he had a handsome and expressive countenance, with much openness of manner and liveliness of conversation, so that he often charmed those who disapproved of his wild freaks. Like John Hunter, he had a free youth, and if unimproved was likewise unspoiled by systematic training.

Both the grandfather and the uncle of Astley Cooper, the latter a lecturer at Guy’s, are credited with some share in exciting a surgical bias in the boy’s mind. Visiting the Norwich hospital one day, and seeing a striking operation, he was strongly impressed with the utility of surgery. In 1784 a visit from his uncle, the London surgeon, led to the nephew being articled to him; but his progress here was limited, owing to the attraction which a free town-life had for him at first. One day he was met by his uncle disguised in the uniform of an officer, and the former recognising his nephew, the latter denied all knowledge of him. The detection of this escapade was soon followed by his transfer as a pupil from his uncle to Mr. Cline, who then shared with Abernethy the next honours as a surgeon to John Hunter. Under Cline, young Cooper imbibed the spirit of Hunter’s teaching from one of his most enthusiastic pupils: for Cline’s judgment about Hunter was that there seemed no comparison between his great mind and all who had preceded him.

Sir Astley Cooper at a later period thus depicts his old master: “Mr. Cline was a man of excellent judgment, of great caution, of accurate knowledge; particularly taciturn abroad, yet open, friendly, and very conversationable at home. In surgery cool, safe, judicious; in anatomy sufficiently informed. In politics a Democrat, living in friendship with Horne Tooke. In morals thoroughly honest; in religion a Deist. A good husband, son, and father. As a friend sincere, but not active; as an enemy most inveterate.”

Young Cooper was soon actively engaged in dissection, and his adventurous nature found scope in many a night-expedition with the body-snatchers or resurrectionists in their search for “subjects.”

He spent one winter session (1787-8) at Edinburgh, having already made considerable progress in anatomy and surgery. He greatly appreciated Cullen, Black, and Fyfe. Having returned from Edinburgh, he attended John Hunter and other celebrated lecturers, and in 1789, being only 21, he was appointed demonstrator at St. Thomas’s. Two years later Mr. Cline obtained for him the joint lectureship with himself in anatomy and surgery. In December 1791 he married Miss Anne Cock. The wedding was perfectly quiet owing to the recent death of the lady’s father, and on the evening of the same day Astley Cooper lectured on surgery with his usual composure, without any of his pupils becoming aware of his marriage. In June 1792 the young surgeon and his bride visited Paris, and were there during the three terrible months which followed. Cooper spent much time in studying Parisian methods of surgery and in attending the debates of the National Assembly. His safety was secured by a democratic badge, and by friendship with leading revolutionists in England to whom Cline adhered.

In addition to his income from his hospital lectures, Mr. Cooper came into possession by his marriage of a fortune of fourteen thousand pounds, so that he was at once placed beyond any pecuniary anxiety. He consequently was enable to devote himself mainly to study and teaching. He went to the hospital before breakfast to dissect for lecture, and he also demonstrated to students before the lecture-hour. He injected their subjects, lectured from two till half-past three, and three evenings a week lectured on surgery. Further, he persevered in visiting the interesting cases in the hospital and making notes of them. His lectures on surgery, which he was the first in the Borough hospitals to separate from anatomy and physiology, were not at the beginning a conspicuous success. He found that he had been too theoretical, but soon changed his plan, and selected cases in the hospital as the basis of his lectures. From this moment his class increased and became interested. He himself acquired a facility in recalling cases and circumstances illustrative of the disease under consideration which greatly added to the attractiveness of his style. The fact is, he was not the intellectual successor of John Hunter, and could not succeed by similar methods. Yet the influence of Hunter upon him was unmixedly beneficial; he had the wit to perceive that Hunter was not “an imaginative speculator, and any one who believed in him a blockhead and a blacksheep in the profession.” The improved lectures on surgery attracted twice as many entries in 1793 as in 1792, and Mr. Cooper was besides selected as lecturer on anatomy at the College of Surgeons. A chief part of his duties in this latter capacity was to lecture on and dissect the bodies of executed criminals. The lectures were most successfully given to crowded audiences. In 1797 the now rising surgeon removed from his early residence in Jeffries Square, St. Mary Axe, to 12 St. Mary Axe, long occupied by Mr. Cline, who now moved westward. In the next year he had a severe accident, being thrown from his horse on his head, and his life was in considerable danger for some time. The extent of Mr. Cline’s consolatory sympathy, when Cooper was lamenting the risk to his life because of its interference with some professional inquiry likely to be of public benefit, was thus expressed: “Make yourself quite easy, my friend; the result of your disorder, whether fatal or otherwise, will not be thought of the least consequence by mankind.”

An early pupil, Dr. William Roots, however, gives a very different account of Cooper’s “consequence to mankind.” “From the period of Astley’s appointment to Guy’s until the moment of his latest breath, he was everything and all to the suffering and afflicted; his name was a host, but his presence brought confidence and comfort; and I have often observed that on an operating day, should anything occur of an untoward character in the theatre, the moment Astley Cooper entered, and the instrument was in his hand, every difficulty was overcome, and safety generally ensued.” No doubt reference is here made to the fact recorded by Sir Astley himself as follows: “I was always of opinion that Mr. Cline and I gained more reputation at the hospitals by assisting our colleagues than by our own operations, for they were always in scrapes, and we were obliged to help them out of them.”

Mr. Travers, who became Astley Cooper’s articled pupil in 1800, says at that time he was the handsomest, most intelligent-looking and finely formed man he ever saw. According to the custom of his time, he wore his hair powdered, with a queue, and had always a glow of colour in his cheeks. In his daily ride he wore a blue coat and yellow buckskin breeches and top-boots. He was remarkably upright, and moved with grace, vigour, and elasticity, and would not unfrequently throw his well-shaped leg upon the table at lecture, to illustrate some injury or operation on the lower extremity. Cheerfulness of temper amounting to vivacity, and a relish for the ludicrous, never deserted him, and his chuckling laugh, scarce smothered while he told his story, his mirthful look and manner, and his punning habit, were well known. His personal habits were very simple; he drank water at dinner, and took two glasses of port after. A good digestion never forsook him; as he said, “he could digest anything but sawdust.” He was remarkable for requiring little amusement or company beyond what he found in his professional pursuits; and he read comparatively little medical literature.

It has often been alleged that Astley Cooper was somewhat unfeeling in nature; and it must be admitted that he had not a deep sympathy with bodily pain, for his own insusceptibility was equalled by his physical endurance. Yet he always sympathised deeply with mental suffering, and Mr. Travers, who saw him read a posthumous letter from a favourite pupil who had committed suicide, relates that his utterance was choked with sobs, and he wept as for the loss of an only child. That his affection was not restricted to his own immediate family is shown by the fact that on the deeply regretted death of his little daughter he adopted into his family a little girl who was no relative, but whose mother died early; and subsequently he himself brought from Yarmouth in the coach, a twenty hours’ journey, his little nephew, Astley, then two years old, who subsequently became his successor in the baronetcy.

More widely known than the nephew during Sir Astley’s life was his servant, Charles Osbaldeston—a name which in practice softened down into Balderson. He was keenly alive to his master’s interest, and had much tact and disposition for manœuvre; he boasted that in twenty-six years he never lost a patient for his master whom it was possible to retain. Wherever Mr. Cooper was, Charles would start after him, if urgently required, and at any cost of post-horses track him out and bring him triumphantly to the fore.

Mr. Cooper in his earlier years, when anatomy formed a great part of his work, was of necessity largely concerned with the resurrectionists, and was one of the main supporters, it may be equally conceded, of their practices, the details of which he was not unfrequently made acquainted with. But the state of the law, which almost made it impossible to gain possession of subjects for dissection legally, must be accepted as the apology for much that would now as then be regarded as shocking. It cannot be strictly germane to Sir Astley Cooper’s life to describe the procedure of the body-snatchers, as Mr. Bransby Cooper has done;[17] but it may be remarked that on occasions when public notice was threatened, Astley Cooper took prompt steps to obviate injurious publicity of his name. For a time the men of ill-fame reigned supreme, exacting almost what prices they chose. If any demur was made, they stopped the supplies, and then the medical students became angry, held indignation meetings, sent deputations to their teachers, sometimes asserting that their lecturers were not as active or as liberal as those of some rival school, and threatening to leave en masse. Thus the lecturers were in a manner forced to pay more for their subjects than they could receive from their pupils for dissecting them. Another disagreeable consequence was, that when the regular “resurrectionists” got into trouble, the surgeons had to make great exertions in their behalf, and often advanced large sums to defend them, or to keep them and their families during imprisonment. Sir Astley Cooper spent hundreds of pounds in this way. One of his accounts includes £14, 7s. for half the expenses of going down and bailing Vaughan at Yarmouth, £13 for Vaughan’s support during twenty-six weeks’ imprisonment, £50, 8s. for four subjects, paid to Murphy, and six guineas “finishing money” to three men, a douceur at the end of a session.

The high prices paid led some people to offer their bodies before death; but of course this was illegal. Sir Astley’s brief answer to one offer from a third party asking to know the truth, was—“The truth is that you deserve to be hanged for making such an unfeeling offer.” But under other circumstances, when the obtaining of the corpse of a person who had died after an operation interesting to the surgeon was in question, Sir Astley paid large sums, and was thus enabled to add many valuable specimens of surgical results to his museum. Thus his accounts for 1820 show the following entries in regard to obtaining the body of a man on whom he had operated twenty-four years before: “Coach for two there and back, £3, 12s.; guards and coachmen, 6s.; expenses for two days, £1, 14s. 6d; carriage of subject, and porter, 12s. 6d.; subject, £7, 7s.; total, £13, 12s.”

This subject was to be obtained, we read, “cost what it may.” It is no wonder, then, that of Sir Astley it might be said that no man knew so much of the habits, the crimes, and the few good qualities of the resurrectionists. He could obtain any subject he pleased, however guarded: and indeed offered to do so. No one could go further than he did before a Committee of the House of Commons, to whom he plainly avowed: “There is no person, let his situation in life be what it may, whom, if I were disposed to dissect, I could not obtain. The law only enhances the price, and does not prevent the exhumation.” At last the dreadful disclosures about the practices of “burking” in Edinburgh in 1829 led to the passing of the Anatomy Act, legalising dissection under proper regulations.

Nor were human bodies the only ones laid under contribution by Astley Cooper. When animals were wanted for some physiological illustration or investigation, his man Charles could always procure them, and he had at one time as many as thirty dogs, besides other animals, shut up in the hayloft. Half-a-crown a piece was paid by Charles on receipt of the dogs, however obtained, and no doubt dog-stealing was one source. The menagerie at the Tower was to Mr. Cooper, as it had been to John Hunter, a considerable resource for specimens for dissection. In 1801 an enormous elephant came under his knife, and being too unwieldy to be got into the dissecting-room, it had to be cut up in the courtyard, where, assisted by several students, Mr. Cooper gave himself no rest till all the interesting parts were preserved and deposited in St. Thomas’s Museum. Bird-stuffers, fishmongers, and poultry merchants were also among the sources of supply for his unwearying knife.

To Astley Cooper, as to most men who rise to eminence, remunerative practice came but slowly. “My receipt,” says he, “for the first year was £5, 5s; the second, £26; the third, £54; the fourth, £96; the fifth, £100; the sixth, £200; the seventh, £400; the eighth, £610; the ninth (the year in which he was appointed surgeon to the hospital), £1100.” This was in 1800, when his uncle, William Cooper, resigned the surgeoncy. It might have been supposed that the uncle would favour his nephew’s succession in every way possible; but he rather supported Mr. Morris, the strongest competitor. For the rising star made the elder jealous of his brilliancy, and moreover always regarded Cline, at St. Thomas’s, as his uncle’s superior. Thus Astley Cooper’s success was by no means certain, as his political associations with Horne Tooke and Thelwall were strenuously alleged against him. But Astley, ever preferring success to politics, resolved on giving up the latter and on being neutral for the future, at any rate as to all open proceedings. This resolve secured his appointment by Mr. Harrison, the well-known treasurer of Guy’s, who with Sir Astley shares the highest credit in the establishment of its medical school. He now absented himself from Mr. Cline’s political parties, and always advised young surgeons not to attach themselves to particular parties, as their duties must extend to persons of all views. He also, to leave no stone unturned, personally canvassed each of the seventy-two governors.

In 1800 Astley made his first communication to the Royal Society, on the effects of destruction of the tympanic membrane of the ear. He had found that considerable openings might be made in the membrane without impairing the hearing power. He consequently applied this operation to certain kinds of deafness resulting from disease or obstruction in the Eustachian tube, and in 1801 sent in another paper detailing the results of twenty cases. Although his success in restoring lost hearing was much less than he had anticipated, the operation has since been frequently performed, and the Royal Society in 1802 awarded him the Copley Medal for these papers. In the same year he was elected F.R.S.

Astley Cooper’s activities were at this time strongly directed towards the improvement of his profession by intercourse and discussion at societies, of several of which he was the life and soul. The Physical Society at Guy’s Hospital afforded his earliest opportunity of this kind, and long retained his active interest. During his short stay at Edinburgh his predominance was so evident that he was chosen president of a society to protect students’ rights against usurpations by the professors. Here also he joined a Speculative Society, and read a paper in favour of the Berkeleian theory of matter. One of the debates which he opened was on the subject “Is man a free agent?” He would have been a president of the Royal Medical Society at Edinburgh had he returned for a second winter, so much did he distinguish himself in debate. At a later period the strength of his association with Edinburgh was attested by his forming the Edinburgh Club in London for former Edinburgh medical students. The most important society, however, with the foundation of which he was connected, was the Royal Medical Chirurgical Society, which originated in a secession from the Medical Society of London. Dr. Yelloly, who was intimately connected with the new foundation, says of Mr. Cooper at this time: “I never saw any one more open-hearted as a companion, more unreserved in his remarks, with always a large store of information at his command, and who was at the same time more kindly disposed, and abounding in all sorts of material for the gratification of those with whom he associated. He was not a reading man; but he contrived to get the most valuable information of every description, whether professional or general, and always to use it in the best, the most attractive, and the readiest way.” The treasurer of the society was Astley Cooper, and he rendered essential service. The earliest volume of its Transactions, published in 1809, contained a paper recording his first operation for the relief of aneurism of the carotid artery by tying it below the aneurism—a method now established. But he had previously published (part 1 in 1804, part 2 in 1807) a work which largely contributed to his reputation, namely, on Hernia or Rupture. A second edition was published in 1827. The anatomical structures concerned were excellently expounded and illustrated, and the experience gained in frequently and successfully operating in cases of this disease gave Mr. Cooper a position of the highest authority. As so often happens to medical men, his attention was especially called to this disease from the fact that he had been subject to it from early life. The anatomical study he undertook in order to perfect his knowledge of this matter was immense. “I have related no case,” he says, “and given no remark, for the truth of which I cannot vouch.” When his pupils showed him some interesting appearance in a dissection, he would say; “That is the way, sir, to learn your profession. Look for yourself; never mind what other people may say, no opinion or theories can interfere with information derived from dissection.” The expense of the illustrations to this work was so great that Mr. Cooper was loser of a thousand pounds by it when every copy had been sold.

In 1806 Mr. Cooper left St. Mary Axe to occupy the house in New Broad Street which for nine years was crowded by his patients, during the most remunerative years of his life. In those years he rose at six, dissected privately till eight, and from half-past eight saw large numbers of gratuitous patients. At breakfast he ate only two well-buttered hot rolls, drank his tea, cool, at a draught, read his paper a few minutes, and then was off to his consulting-room, turning round with a sweet benign smile as he left the room. Patients crowded his rooms and besieged “Charles,” using manifold devices to get the earliest interview possible. At one o’clock he would scarcely see another patient, even if the house was full; but if detained half an hour later, would fly into a rage, abuse Charles, and jump into his carriage, leaving Charles to appease the disappointed patients. Sometimes the people in the hall and ante-room were so importunate that Mr. Cooper was driven to escape through his stables and into a passage by Bishopsgate Church. At Guy’s he was awaited by a crowd of pupils on the steps, and at once went into the wards, addressing the patients with such tenderness of voice and expression that he at once gained their confidence. His few pertinent questions and quick diagnosis were of themselves remarkable, no less than the judicious calm manner in which he enforced the necessity for operations when required. At two the pupils would suddenly leave the ward, run across the street to the old St. Thomas’s Hospital, and seat themselves in the anatomical theatre. After the lecture, which was often so crowded that men stood in the gangways and passages near to gain such portions of his lecture as they might fortunately pick up, he went round the dissecting-room, and afterwards left the hospital to visit patients, or to operate privately, returning home at half-past six or seven. Every spare minute in his carriage was occupied with dictating to his assistants notes or remarks on cases or other subjects on which he was engaged. At dinner he ate rapidly and not very elegantly, talking and joking; after dinner he slept for ten minutes at will, and then started to his surgical lecture, if it were a lecture night. In the evening he was usually again on a round of visits till midnight.

Dr. Pettigrew, in his “Medical Portrait Gallery,” thus vividly describes the overpowering influence Sir Astley had upon his pupils: “I can never forget the enthusiasm with which he entered upon the performance of any duty calculated to abridge human suffering. This enthusiasm, by the generosity of his character, his familiar manner, and the excellence of his temper, he imparted to all around him; and the extent of the obligations of the present and of after ages to Sir Astley Cooper, in thus forming able and spirited surgeons, can never be accurately estimated. He was the idol of the Borough School. The pupils followed him in troops; and, like to Linnæus, who has been described as proceeding upon his botanical excursions accompanied by hundreds of students, so may Sir Astley be depicted traversing the wards of the hospital with an equal number of pupils, listening with almost breathless anxiety to catch the observations which fell from his lips. But on the days of operation this feeling was wound up to the highest pitch. The sight was altogether deeply interesting; the large theatre of Guy’s crowded to the ceiling—the profound silence obtained upon his entry—that person so manly and so truly imposing—and the awful feeling connected with the occasion—can never be forgotten by any of his pupils. The elegance of his operation, without the slightest affectation, all ease, all kindness to the patients, and equally solicitous that nothing should be hidden from the observation of the pupils; rapid in execution, masterly in manner; no hurry, no disorder, the most trifling minutiæ attended to, the dressings generally applied by his own hand. The light and elegant manner in which Sir Astley employed his various instruments always astonished me, and I could not refrain from making some remarks upon it to my late master, Mr. Chandler, one of the surgeons to St. Thomas’s Hospital. I observed to him, that Sir Astley’s operations appeared like the graceful efforts of an artist in making a drawing. Mr. C. replied, ‘Sir, it is of no consequence what instrument Mr. Cooper uses, they are all alike to him; and I verily believe he could operate as easily with an oyster-knife as the best bit of cutlery in Laundy’s shop.’ There was great truth in this observation. Sir Astley was, at that time, decidedly one of the first operators of the day, and this must be taken in its widest sense, for it is intended to include the planning of the operation, the precision and dexterity in the mode of its performance, and the readiness with which all difficulties were met and overcome.”

Mr. Cooper, notwithstanding his persevering industry in dissection, would not have found time to acquire all the knowledge he did, but for employing several assistants either to dissect the specimens he obtained from operations or from post mortem examinations, or as artists and modellers, amanuenses, &c. He was very peremptory in his orders to his assistants to obtain for him any specimen he required, and would not listen to suggestions of difficulties. “So and so must be done,” he said, and his tone did not admit of the possibility of failure. Thus he accumulated the large collection of morbid specimens which he contributed to St. Thomas’s Hospital, at a time when such collections were poohpoohed, and so little regarded, that he could readily obtain any specimen he desired which was at the disposal of his colleagues. With regard to his proceedings in these matters the utmost secrecy was observed, entrance to his private dissecting-rooms being jealously restricted to himself and his paid assistants. When it was difficult to obtain leave to make a post mortem examination in private practice, he would spend a long time in arguing most strenuously upon the matter with the relatives, pointing out the reasons which rendered it desirable in the interests of science. His only child was examined by his express wish by a friend; and he left strict injunctions and directions for the post mortem on his own body. In very few cases was his determination ever frustrated.

Astley Cooper reached his zenith in Broad Street. In one year his income reached £21,000; for many years it was £15,000. One merchant prince paid him £600 a year; the story of another, who tossed him a cheque for a thousand guineas in his night-cap, after a successful operation for stone, is well known. Many of his patients wrote a cheque for their fee when they consulted him, and never made it less than five guineas. It is amusing to contrast with his reputation as a surgeon and operator, the extremely limited pharmacopœia to which he trusted. “Give me,” he would say, “opium, tartarized antimony, sulphate of magnesia, calomel and bark, and I would ask for little else:” and from five or six formulæ he gave his poorer patients a constant stock of medicine.

Mr. Cooper was appointed Professor of Comparative Anatomy at the Royal College of Surgeons in 1813, being the first appointment after Sir Everard Home retired. He lectured during only two seasons, in 1814 and 1815. Not being deeply read in his subject, he resolved to see what industry could do, and restricted himself to three or four hours’ sleep, that he might gain additional time for the dissection of animals. He also employed several assistants to dissect for him, and the result was that his specimens came by coach-loads to each lecture. Mr. Clift remarks of one lecture, “This was an overpowering discourse, and highly perfumed, the preparations being chiefly recent and half-dried and varnished.” His lectures were very successful, though he would have preferred lecturing on surgery, which was allotted to Abernethy. In the year last mentioned he resigned the professorship and also moved to New Street, W., hoping thereby to diminish the fatigue occasioned by the numerous visits which he had to pay westward. In the following May he signalised his skill by his celebrated operation of tying the aorta or principal artery of the body, for aneurism, in a case in which life was in the extremest peril. The ease with which he prepared for the operation and the masterly skill and success with which he completed it—without the aid of chloroform, be it remembered—excited admiration throughout the profession, who could best judge of the difficulties which had to be overcome. The patient died of incurable disease, but the success of the operation was undoubted.

After having for some years attended Lord Liverpool, Mr. Cooper was in 1820 called in to George IV., who afterwards insisted on his performing a small operation upon him, although he then held no court appointment. He was very reluctant, fearing erysipelas, and only at length yielded to command. His success in this was followed by the conferment of a baronetcy, which was hailed with acclamation by all his friends both professional and public.

In 1822 Sir Astley first became an Examiner at the College of Surgeons. In this capacity he was very conscientious and considerate, never asking catch-questions, or making abstract inquiries, but invariably dwelling upon practical matters, and putting his questions in simple and straightforward language. In the same year appeared perhaps his most important work, that on Dislocations and Fractures of the Joints, and as was his fixed principle, he published it at a price just sufficient to cover the cost of the letterpress and engravings.

In January 1825 Sir Astley resigned his lectureship at St. Thomas’s, owing to the impairment of his health. Mr. Key had previously been delivering part of his surgical course, and his nephew Bransby Cooper had undertaken the anatomical lectures; and Sir Astley was determined to secure their succession to his appointments. He had only resigned in the firm conviction that this was generally agreed upon. His astonishment may be imagined when he learnt that Mr. South had been appointed anatomical lecturer. Sir Astley, desiring to withdraw his resignation, was informed that it was too late. Mr. Harrison, however, the then spirited treasurer of Guy’s, came to the rescue, and offered to establish a school of medicine at Guy’s, totally independent of St. Thomas’s, and to appoint Mr. Key and Mr. Bransby Cooper to the chairs of surgery and anatomy. This was at once agreed to, and a lecture theatre and other premises hastily built during the summer, so that the new school of Guy’s was opened in the succeeding October. A large proportion of the old pupils of the united schools of St. Thomas’s and Guy’s entered at Guy’s, and a considerable number of new pupils coming up, the now famous school was prosperously floated. Sir Astley did not lecture much for the new school, though he gave a few occasional lectures on anatomy and surgery, which of course were crowded to excess. He now became consulting surgeon to Guy’s, and evidenced his zeal by commencing the formation of a museum like that which he had already deposited at St. Thomas’s, and which he would have removed thence had it been in his power. In 1827 he was elected President of the College of Surgeons.

By this time Sir Astley had adopted the habit of spending as much of his time as possible on his estate at Gadesbridge, near Hemel Hempstead. Here he became a rural character, shooting and “making shoot” with eagerness and joviality. Lady Cooper, having lost her adopted daughter, Mrs. Parmenter, and having had no second child, could not endure living in London. In 1825, Sir Astley took his home-farm upon his hands, and kept it in consummate order, at considerable expense, it must be owned. He was always either experimenting or trying to carry out some new plan he had heard of or observed. He again and again became violently angry, as he grew older, when he found that his ideal farm only produced substantial loss: and used repeatedly to vow he would never allow such passion to overcome him again. One of his experiments in farming was the purchase of lame or ill-fed horses at Smithfield at from five to seven pounds apiece, feeding and doctoring them himself at Gadesbridge, and turning them into much better animals. He sometimes made a good profit in this way, and for years drove in his own carriage horses that had only cost him twelve pounds ten. If they were past cure, he would experiment upon them according to what investigation he might have in progress at the time.

Lady Cooper’s death in June 1827 was a heavy blow to Sir Astley, and he was so much affected by it that he resolved to retire altogether from practice. Before the end of the year, however, he found the ennui of retirement insupportable, and returned to town and full practice again. He was married a second time to Miss C. Jones in July 1828. The same year he was appointed Sergeant-Surgeon to the King, an appointment in which he was continued at William IV.’s accession. Having no lectures, he still dissected, and occupied himself largely with completing his various works for the press. His “Illustrations of Diseases of the Breast” appeared in 1829, and was followed by “Diseases of the Testis,” 1830, “The Anatomy of the Thymus Gland,” 1832. He was for a second time President of the Royal College of Surgeons in 1836.

In his old age, even when travelling about, Sir Astley never lost his passion for dissecting, and always visited every hospital and surgeon of note on his travels. He never liked staying more than a few days in one place; he soon began to pine after his accustomed pursuits. On several occasions, when detained longer than he liked in one place, he would get up early and leave by coach for London, without giving any warning of his intention.

On a visit which he made to Edinburgh in 1837, the freedom of the city was conferred upon him and the honorary LL.D. He had previously been made D.C.L. of Oxford. He continued his anatomical and surgical investigations to the last, publishing a splendid work on the Anatomy of the Breast in 1840, preliminary to a complete account of the diseases to which it is liable, which was never completed. He died on the 12th of October 1841, in the seventy-third year of his age, at Conduit Street, where he had practised latterly. He was buried, by his own particular request, beneath the chapel of Guy’s Hospital. A statue of him, by Baily, was erected, chiefly by the members of the medical profession, in St. Paul’s Cathedral, near the southern entrance. An admirable portrait of him by Sir Thomas Lawrence exists. Sir Astley’s name is commemorated by the triennial prize essay of three hundred pounds for the best original prize essay on a professional subject, to be adjudicated by the physicians and surgeons of Guy’s, who may not themselves compete.

A criticism on Sir Astley during his life accorded to him a great share in establishing pure induction as the only sure means of just diagnosis, and in introducing a simplicity of treatment in accordance with the processes of nature. Before his time, operations were too often frightful alternatives or hazardous compromises; he always made them follow, as it were, in the natural course of treatment; and he succeeded in a great degree in divesting them of their terrors by performing them unostentatiously, confidently, and cheerfully. He stated an opinion and fact to the Committee on Medical Education, which might well have been borne in mind by some examiners since his day: “Whenever a man is too old to study, he is too old to be an examiner; and if I laid my head upon my pillow at night, without having dissected something in the day, I should think I had lost that day.” Sir Astley left among his private papers an estimate of himself, written in the third person, which is worth quoting. “Sir Astley Cooper was a good anatomist, but never was a good operator where delicacy was required. He felt too much before he began ever to make a perfect operator.... Quickness of perception was his forte, for he saw the nature of disease in an instant, and often gave offence by pouncing at once upon his opinion. The same faculty made his prognosis good. He was a good anatomist of morbid, as well as of natural structure. He had an excellent and useful memory. In judgment he was very inferior to Mr. Cline in all the affairs of life.... His imagination was vivid, and always ready to run away with him if he did not control it.”

“His principle in practice was, never to suffer any who consulted him to quit him without giving them satisfaction on the nature and proper treatment of their case.”

Finally, he says, what is a fitting close to this narrative of his career, “My own success depended upon my zeal and industry; but for this I take no credit, as it was given to me from above.”

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Another pupil of John Hunter, a man of very different mould, in several respects more akin to the master than Sir Astley, now claims our attention. Unlike many of the great men whose achievements we have recorded, John Abernethy was born in London, in the parish of St. Stephen’s, Coleman Street, on the 3d of April 1764. He was the second son of John Abernethy, merchant, descended from an Irish-Scotch family which had furnished more than one noted man to the Protestant dissenting ministry in Ireland. While very young he was sent to the Wolverhampton Grammar School under Dr. Robertson. Here he was reputed studious and clever, but was evidently passionate as well as humorous. The severe discipline common at that time does not seem to have worked very well with Abernethy, for he came out of it more excitable and impatient than he had been previously. School days were over at fourteen, however, and at fifteen the youth was apprenticed to Mr., afterwards Sir Charles, Blicke, his father’s neighbour in Mildred’s Court, one of the surgeons to St. Bartholomew’s Hospital. His own desire was to enter the legal profession, in which his fine memory would have rendered him important service; but his father did not agree with this choice, and the medical profession was selected. His master was an empiric; but Abernethy early determined to get to the bottom of things as far as possible, and engaged in investigations on his own account. The bent of his mind towards treatment by diet is shown by the following statement. “When I was a boy,” he said, “I half ruined myself in buying oranges and other things, to ascertain the effects of different kinds of diet in this disease” (of the kidney).

Abernethy’s interest in anatomy and surgery was first effectively stimulated by Sir William Blizard, who lectured at the London Hospital, and he warmly acknowledged this in his introductory lecture at the College of Surgeons in 1814, when he succeeded Sir William as professor. He was soon selected to dissect for Sir William’s lectures; he derived much benefit from Pott’s surgical lectures at St. Bartholomew’s, and from Dr. Marshall’s lectures in Holborn; but was most powerfully influenced by John Hunter, who noted him among his most intelligent pupils. The opportunity of becoming an assistant-surgeon, being reserved to apprentices of the surgeons to St. Bartholomew’s, came early to Abernethy, for his master’s promotion to the surgeoncy led to his election as assistant-surgeon in July 15, 1787, when only twenty-three years old, by a majority of fifty-three to twenty-nine votes. But he was under the necessity, owing to his senior’s remaining so long in office, of continuing as assistant-surgeon for the long period of twenty-eight years.

The young surgeon soon began to put his original powers in evidence by starting as a lecturer. Mr. Pott had for years given a course of lectures on surgery, but no other lectures had been delivered, and the medical school of St. Bartholomew’s must be regarded as owing its establishment to Abernethy. To be the life and soul of a new school is enough for any man in his maturest years; it was more than enough for Abernethy, beginning at twenty-three, when everything was new, and precedents were few, and when his own faculties and studies still lacked much. To this we must largely attribute the worn-out look which began to settle upon his face from the age of fifty. He was not content in his lecturing with any dry and orderly narration, but combined with his descriptive account the purposes of a structure, the diseases and accidents to which it is liable, and illustrations from comparative anatomy. He for a long time included in his courses at once anatomy, physiology, pathology, and surgery; at the same time he kept up his attendance on John Hunter’s lectures, and diligently studied in the wards of the hospital. His industry at this period was such that he rose at four, and sometimes went into the country that he might read with less interruption. It may seem strange, in connection with the well-known brusqueness of his manner, to read that he had an unconquerable shyness in his early years of lecturing, which often made him retire from the theatre to regain his composure before being able to commence his lecture. But this shyness is often a concomitant of real talent and originality before it has found means to display itself effectively; and brusqueness is in not a few instances the cloak of timidity. When his dramatic instincts had led him into his true path, he soon gained in ease, and his classes increased so rapidly that in 1790 the governors of St. Bartholomew’s resolved to build him a theatre, which was opened in October 1791.

Abernethy’s style in lecturing is described by those who heard him as unique both in communicating his ideas and in interesting his pupils. When his style had fully developed, it was spoken of as “Abernethy at Home.” His mode of entering the lecture-room, says Pettigrew, was often irresistibly droll; his hands buried deep in his breeches-pockets, his body bent slouchingly forward, blowing or whistling, his eyes twinkling beneath their arches, and his lower jaw thrown considerably beneath the upper. Then he would cast himself into a chair, swing one of his legs over an arm of it, and commence his lecture in the most outré manner. The abruptness, however, never failed to command silence, and rivet attention.

“‘The count was wounded in the arm—the bullet had sunk deep into the flesh—it was, however, extracted—and he is now in a fair way of recovery.’ That will do very well for a novel, but it won’t do for us, gentlemen: for ‘Sir Ralph Abercromby received a ball in the thick part of his thigh, and it buried itself deep, deep: and it got among important parts, and it couldn’t be felt; but the surgeons, nothing daunted, groped, and groped, and groped,—and Sir Ralph died.’” Thus he would introduce an admirable discourse on gunshot wounds, reprobating in the strongest language the perilous and painful practice of making prolonged searches for bullets in important organs. He always illustrated his subject by telling anecdotes, frequently of a side-splitting character, and so compelled his pupils to remember his doctrines.

His mental abstraction was not unfrequently manifested strikingly in the lecture-theatre. On one occasion it is related of him that at an introductory lecture at St. Bartholomew’s, when he had been received, as usual, with great applause, he appeared utterly indifferent to it, but quietly casting his eyes over the assemblage, burst forth in a tone of deep feeling, “God help you all! what is to become of you!”

His dramatic power was much employed in imitating his patients’ peculiarities, with a mixture of the serious and the humorous which was most effective. Many of his stories were most apt in their bearing on some important fact or principle. One of these we may be allowed to quote from Macilwain.[18]

“Ah, there is no saying too much on the importance of recollecting the course of large arteries; but I will tell you a case. There was an officer in the navy, and as brave a fellow as ever stepped, who in a sea-fight received a severe wound in the shoulder, which opened his axillary artery. He lost a large quantity of blood, but the wound was staunched for the moment, and he was taken below. As he was an officer, the surgeon, who saw he was wounded severely, was about to attend to him, before a seaman who had been just brought down. But the officer, though evidently in great pain said: ‘Attend to that man, sir, if you please, I can wait.’ Well, his turn came; the surgeon made up his mind that a large artery had been wounded; but as there was no bleeding, dressed the wound, and went on with his business. The officer lay very faint and exhausted for some time, and at length began to rally again, when the bleeding returned; the surgeon was immediately called, and not knowing where to find the artery, or what else to do, told the officer he must amputate his arm at the shoulder-joint. The officer at once calmly submitted to the additional but unnecessary suffering; and as the operator proceeded, asked if it would be long; the surgeon replied that it would be soon over; the officer rejoined: ‘Sir, I thank God for it!’ but he never spake more.”

Amidst death-like stillness, Abernethy quietly concluded: “I hope you will never forget the course of the axillary artery.”

It has been, we believe, a somewhat general impression, that Abernethy as a lecturer indulged in tricks or extraordinary gesticulations. But this is by no means correct. There was a method in every item of his procedure, and all he aimed at was to impress upon the students’ minds in the most forcible and abiding way the ideas he wished to convey. He gained, it is said, the appearance of perfect ease without the slightest presumption; and had no offensive tricks. Macilwain, who was his pupil at his best period, says: “The expression of his countenance was in the highest degree clear, penetrative, and intellectual; and his long but not neglected powdered hair, which covered both ears, gave altogether a philosophic calmness to his whole expression that was peculiarly pleasing. Then came a sort of little smile, which mantled over the whole face, and lighted it up with something which we cannot define, but which seemed a compound of mirth, archness, and benevolence.... There was a sort of running metaphor in his language, which, aided by a certain quaintness of manner, made common things go very amusingly. Muscles which pursued the same course to a certain point, were said to travel sociably together, and then to part company. Blood-vessels and nerves had certain habits in their mode of distribution, contrasted in this way; arteries were said to creep along the sides of or between muscles: nerves, on the contrary, were represented as penetrating their substance without ceremony.... He was particularly happy in a kind of cosiness or friendliness of manner which seemed to identify him with his audience; as if we were all about to investigate something interesting together, and not as if we were going to be ‘lectured’ at at all. He spoke as if addressing each individual, and his discourse, like a happy portrait, always seemed to be looking you in the face.”

In consultation or in ordinary practice, Abernethy was only rough and hasty when something annoyed him. Towards his fellow-practitioners who could give a reason for their opinions or their treatment, he was polite and even deferential. He never recommended interference with judicious plans of cure in order to gain éclat for himself, nor unless some important end were to be obtained. He was no party to concealments or deceptions being practised on the friends of patients, and in many cases told the plainest of plain truths to patients themselves. “Pray, Mr. Abernethy, what is a cure for gout?” was the question of an indolent and luxurious citizen. “Live upon sixpence a day—and earn it,” was the cogent reply. He is reported to have been consulted by the Duke of York; and to have stood before him, as usual, whistling, with his hands in his breeches-pockets. The astonished Duke remonstrated: “I suppose you know who I am.” “Suppose I do,” replied Abernethy, “what of that?” And he advised the Duke, in reference to his complaint: “Cut off the supplies, as the Duke of Wellington did in his campaigns, and the enemy will leave the citadel.” A barrister came to Mr. Abernethy with a small ulcer on his leg, which had proved difficult to heal. Having heard much of his impatience and peculiar manners, he began to pull down his stocking as soon as he entered his consulting-room. “Holloa! holloa! what the devil are you at?” exclaimed the surgeon. “I don’t want to see your leg; that will do, put it up, put it up.” The patient did so, but marked his displeasure by placing only a shilling upon the table when he left. “What is this?” asked Abernethy. “Oh,” replied his patient, “that will do, put it up, put it up,” and coolly retired.

It is said that Abernethy’s impatience frequently arose from his anxiety to be at his hospital duties; and that instead of representing this in a proper manner, he would sometimes almost push patients from his door. Sir Astley Cooper received many a fee from those who had quitted Abernethy, or would not venture to encounter his rudeness. To his hospital patients, especially those who were in great distress, he was all kindness. Their gratitude was sometimes amusingly demonstrated. Mr. Stowe relates one example of this: “It was on his first going through the wards after a visit to Bath, that, passing up between the rows of beds, with an immense crowd of pupils after him, myself among the rest—the apparition of a poor Irishman, with the scantiest shirt I ever saw, jumping out of bed, and literally throwing himself on his knees at Abernethy’s feet, presented itself. For some moments everybody was bewildered; but the poor fellow, with all his country’s eloquence, poured out such a torrent of thanks, prayers, and blessings, and made such pantomimic displays of his leg, that we were not long left in doubt. ‘That’s the leg, yer honnor! Glory be to God! Yer honnor’s the boy to do it! May the heavens be your bed! Long life to your honnor! To the divole with the spalpeens that said your honnor would cut it off!’ &c. The man had come into the hospital about three months before, with diseased ankle, and it had been at once condemned to amputation. Something, however, induced Abernethy to try what rest and constitutional treatment would do for it, and with the happiest result. With some difficulty the patient was got into bed, and Abernethy took the opportunity of giving us a clinical lecture about diseases and their constitutional treatment. And now commenced the fun. Every sentence Abernethy uttered Pat confirmed. ‘Thrue, yer honnor, divole a lie in it. His honnor’s the grate dochter entirely!’ While at the slightest allusion to his case, off went the bed-clothes, and up went the leg, as if he were taking aim at the ceiling with it. ‘That’s it, by gorra! and a bitther leg than the villin’s that wanted to cut it off!’ This was soon after I went to London, and I was much struck with Abernethy’s manner in the midst of the laughter. Stooping down to the patient, he said with much earnestness: ‘I am glad your leg is doing well; but never kneel, except to your Maker.’”

Many are the stories in which Abernethy’s name appears; many have been exaggerated; many are falsely connected with his name. Sometimes he would, instead of crushing a victim, become sufficiently the victim himself. A lady once said to him: “I had heard of your rudeness before, but I did not expect this.” When he handed her his prescription, she asked: “What am I to do with this?” The rough reply was, “Anything you like. Put it in the fire if you please.” The lady took him at his word, laid down her fee, threw the prescription into the fire, and left the room; nor could Abernethy persuade her to receive her fee again, or a fresh prescription. Notwithstanding all stories to his disadvantage, there is no doubt that Abernethy’s intentions were most kind, and that he never took a fee from a patient who might possibly be unable to afford it comfortably. For these two reasons, his not unfrequent roughness, and his leniency about fees, he certainly had a much smaller income than he might have secured. Yet his income was very considerable, but not carefully managed. One day calling to pay his wine merchant for a pipe of wine, he threw down a handful of notes, and pieces of paper with fees. On being asked to wait till all were accurately counted, as some of the fees might be more than he thought. “Never mind,” said he, “I can’t stop; you have them as I took them,” and hurried away.

It is now time to refer to some of Abernethy’s principal publications. In 1793 he published his first volume of Surgical and Physiological Essays, including his celebrated essay on lumbar abscess, in which he details a simple and beautiful method of cure which has since been largely followed. In the second volume of these essays, a paper on the functions of the skin details some careful experiments upon the air in which the hand or foot had been confined for some time. He detected some carbonic acid in such air, and founded upon the experiments important views as to the necessity of keeping the skin cleansed and in healthy action. The third part of these essays, published in 1797, contained an important paper on injuries of the head, deprecating among other things all unnecessary interference, and so preventing many a fruitless operation. In 1806 appeared Abernethy’s Surgical Observations, including an account of the disorders of health in general, and of the digestive organs in particular, which accompany local diseases, and obstruct their cure. Whenever he wished to impress upon a patient or a practitioner the importance of attending to the general health, and the stomach in particular, if some local disease was to be cured, he always referred to his book, so that his phrase “read my book” was expected as a certainty. But it appeared sometimes as if he perceived disorder of the digestive organs in every case. A lady who had an affection outside the knee-joint occasioned by a blow against the edge of a step, went to Mr. Abernethy, and was about to show the affected part, when he rudely exclaimed, “I don’t want to see your knee, ma’am! allow me,” and pressed his fist with force against her stomach. She of course cried out, and he of course attributed her disorder to her stomach. Nevertheless she recovered without medicine, by strictly local treatment of the knee, under Dr. Pettigrew.

In all Abernethy’s writings there was manifested a lack of good arrangement which contrasts strikingly with his excellence as a lecturer: but in the latter capacity his audience was always before him, and he could see and test the suitability of his matter. Education had not furnished him with real literary training, and his aptness of expression and his wit do not appear to striking advantage in his written works.

Abernethy was married on the 9th January 1800 to Miss Anne Threlfall, whom he had met at a house to which he had been professionally called in. His courtship was brief; his proposals were made by letter; he characteristically deprecated too much “dangling,” gave the lady a fortnight to consider her reply; and was successful. Not for one day did he interrupt his hospital lectures.

In 1815, after twenty-eight years’ tenure of the office of assistant-surgeon, Abernethy became full surgeon on the retirement of his old master, Sir Charles Blicke. He made the appointment the occasion for publishing a pamphlet on the evils attending the prolonged tenure of office by old surgeons. He himself had lectured for twenty-eight years, and been largely influential in filling the hospital with students, from whose hospital fees he received nothing whatever. About the time of his succession to the surgeoncy he took a house at Enfield, to which he resorted on Saturdays, gladly quitting his own house in Bedford Row for a quiet country ride. In the summer he would retire to Enfield on most evenings. This tended very much to the benefit of his fidgety nervous system. From early life his heart had been particularly irritable, causing him frequent suffering. A wound which he accidentally gave himself in dissecting at one time caused him such a severe illness that it was three years before he had recovered from its effects, which appeared in very varied forms. It must be acknowledged, too, that he was not as moderate in eating as he exhorted his patients to be. He frequently was attacked by inflammatory sore-throat, terminating in abscess.

Abernethy resigned his professorship at the College of Surgeons in 1817, and was gratified by a resolution sent to him, thanking him for the distinguished energy and perspicuity which had characterised his lectures. This resignation, however, was not sufficient relief to his overstrained system, which was now often tormented with rheumatism. He took insufficient care of himself, would walk down from Bedford Row to the hospital in knee-breeches and silk stockings when it was raining, without a thought of protecting himself from a drenching. With very cold feet he would stand opposite one of the flue openings in the museum, and this with other imprudences gradually sapped his strength. At the age of sixty, according to the plan he had suggested and strongly advocated, he resigned his appointment as surgeon, but the governors would not accept it. He was persuaded to remain in office some time longer, but finally resigned on July 24, 1827. The succeeding winter was the last in which he lectured, and in 1829 he gave up his examinership at the College of Surgeons. He had now become very lame, thin and old-looking. His eye retained its expressiveness, but showed evidences of the continual pain he suffered. He died on the 20th April 1831, quite worn out, but conscious to the last: he was buried in the parish church of Enfield. Thus early, like John Hunter, died one of his pupils, who, in the words of the Duke of Sussex at the anniversary meeting of the Royal Society in 1831, appears the most completely to have caught the bold and philosophical spirit of his great master.